Are you planning on welcoming a new member into the family soon? There’s a lot of conflicting information online concerning what you should and should not eat during pregnancy. Thankfully, pregnancy nutrition does not have to be complicated.
The diet that is best for pregnancy is the diet that is best for general health, with a few differences. Pregnant women must take some additional precautions to avoid foodborne illness due to pregnancy-related immune system changes. Also, there are elevated needs for certain nutrients during pregnancy to help support the growth and development of the fetus.
As always, the information in this article is not personal medical advice. Your healthcare practitioners know your medical history and are in the best position to give individualized advice to you. If anything in this article conflicts with the recommendations they have given you, their advice must take priority.
Here are the topics we’ll tackle in this article:
- Why is prenatal nutrition so important?
- How much weight should you gain during pregnancy?
- What types of foods should be the mainstays of the pregnancy diet?
- What about morning sickness?
- Which foods should you avoid during pregnancy?
- Are there other ways to help prevent foodborne illness during pregnancy?
- Which nutrients do you need more of during pregnancy?
- What’s the deal with folate and folic acid?
Don’t let pregnancy nutrition stress you out! Aim for a varied diet of healthful foods, and keep reading for some other pointers below.
Why Is Prenatal Nutrition So Important?
Before getting into the risks of poor nutrition, keep in mind that your pregnancy diet does not have to be perfect! For example, it is fine to relax and indulge in your cravings for sweets from time to time.
The adverse outcomes that I’m about to list are related to severe energy or essential nutrient deficits. These are NOT related to enjoying an occasional ice cream or some chocolate.
However, extremely poor nutrition status in pregnancy has been linked to several adverse outcomes. These include higher rates of miscarriage, prolonged labor, low birth weight babies, and congenital malformations. You can reduce your risks by nourishing your body with proper nutrition during this critical time.
How Much Weight Should You Gain During Pregnancy?
Pregnancy is not the appropriate time to set a weight loss goal, no matter what size body you have. Giving your body the nourishment it needs for fetal growth and development is the top priority. Here is where the weight goes when you gain 30 pounds during pregnancy (from March of Dimes):
- Baby: 7.5 pounds
- Fat, protein, other nutrients: 7 pounds
- Blood: 4 pounds
- Body fluids: 4 pounds
- Amniotic fluid: 2 pounds
- Breasts: 2 pounds
- Uterus: 2 pounds
- Placenta: 1.5 pounds
As you can see, most of the weight you will gain in a healthy pregnancy is not body fat! Your pre-pregnancy BMI helps to determine the recommended amount of weight that you should gain during pregnancy. For single baby pregnancies, the targets are as follows (CDC):
- Underweight (BMI under 18.5) should gain 28-40 pounds
- Healthy weight (BMI 18.5-24.9) should gain 25-35 pounds
- Overweight (BMI 25-29.9) should gain 15-25 pounds
- Obese (BMI 30 or above) should gain 11-20 pounds
A standard recommendation is that women aim to gain a total of 1-4 pounds during the first trimester. In the second and third trimesters, women are generally advised to gain 2-4 pounds per month. The recommendations for women pregnant with twins is higher.
Only about one-third of women gain the right amount of weight during pregnancy. One-fifth gain too little, which puts the baby at greater risk for illness and developmental delays.
Maintaining regular healthcare visits and eating a balanced diet can help you to gain the right amount of weight. Getting moderate-intensity physical activity during a healthy pregnancy is considered safe, and can support an optimal rate of weight gain. Aim for at least 150 minutes, spread throughout the week.
Certain types of physical activity may be contraindicated, so check in with your healthcare provider if you have questions. In general, contact and collision sports, as well as activities that carry a risk of falling or trauma should be avoided.
What Types Of Foods Should Be The Mainstays Of The Pregnancy Diet?
The foods that should be mainstays of the ideal pregnancy diet are the same foods recommended in a regular diet. Options that are high in added sugars and saturated fats should be limited. Pack your pregnancy diet with plenty of the following (from the Academy of Nutrition and Dietetics):
- Lean proteins (i.e., meat, poultry, eggs, legumes, nuts, seeds)
- 8-12 ounces of low-mercury seafood per week
- Fruits (fresh, canned, and frozen with no added sugar are all great choices)
- Vegetables (choose “no added salt” versions of canned veggies)
- Dairy products (pasteurized)
- Whole grains (e.g., brown rice, quinoa, whole-wheat pasta, popcorn)
Does this sound very similar to the food groups listed in the Mediterranean diet article? That’s not a coincidence. Make sure that they have a place in your pregnancy diet.
Are you wondering whether you need to give up your morning cup of joe? The American College of Obstetricians and Gynecologists states that up to 200 mg of caffeine is safe per day. That is equivalent to a 12-ounce cup of coffee.
Your needs for hydration also increase during pregnancy. If you haven’t started this habit already, consider carrying a bottle of water with you. That way you will have a drink at hand when you need it, throughout the day.
Most dietitians and doctors will also recommend a prenatal supplement to pregnant women. These multivitamin-mineral supplements help enhance, not replace, a healthy diet.
Taking a daily supplement is an extra precaution to make sure you get enough nutrients like folic acid and iron. Never start taking a supplement during pregnancy without consulting with your healthcare practitioner first.
What About Morning Sickness?
Morning sickness is a widespread occurrence during the first trimester of pregnancy. However, if you really cannot keep any foods down, it is vital to check in with your healthcare practitioner. It is also a good idea to mention it to your doctor if nausea continues beyond your first trimester.
There is a severe condition of nausea and vomiting that can occur in pregnancy called hyperemesis gravidarum (HG). If left untreated, HG can put a pregnant woman at risk for dehydration, electrolyte imbalances, and weight loss. Early treatment of HG can mitigate any complications that can arise from this condition.
Which Foods Should You Avoid During Pregnancy?
Pregnant women do need to take a few extra precautions during pregnancy to prevent foodborne illness. Listeria and some other illnesses can infect the fetus, even if the mother is not showing symptoms. However, avoiding too many foods may put you at a higher risk for nutrient deficiencies.
The U.S. Department of Health & Human Services has a list of foodsafety.gov of foods that pregnant women should avoid. These include:
- Raw fish and shellfish (e.g., sushi, raw oysters, ceviche)
- Smoked seafood that has not been heated to 165ᵒF
- Raw dairy products (only use products made with pasteurized milk)
- Unpasteurized cider or juice
- Undercooked eggs (found in homemade eggnog, raw batter, homemade ice cream, homemade Caesar dressing, and other foods)
- Premade deli salads, deli spreads, or pates
- Raw sprouts
- Undercooked poultry or meat
- Deli meats or hot dogs that have not been reheated to 165ᵒF
- Raw dough (even if the dough contains no eggs, uncooked flour can make you sick)
In addition, the Dietary Guidelines recommend that pregnant or breastfeeding women choose fish that are lower in mercury. The fish with high mercury levels to avoid include:
- King Mackerel
- Orange Roughy
- Bigeye Tuna
It is also important to avoid alcohol during pregnancy. Consuming even moderate amounts of alcohol can increase the baby’s risk for developmental and behavioral conditions. Choosing to avoid alcohol is a great way to help reduce risks to the health of your unborn baby.
Are There Other Ways to Help Prevent Foodborne Illness During Pregnancy?
There are some additional steps that you can take to prevent foodborne illness. These include (from foodsafety.gov):
- Cook fish, steaks, roasts, and chops to an internal temperature of 145ᵒF
- Cook ground meat and egg dishes to 160ᵒF (no runny egg yolks!)
- Cook poultry to 165ᵒF
- Use pasteurized milk, cheese, and cider only
- Clean your hands and kitchen surfaces thoroughly before food preparation
- Keep raw meat and poultry separate from other foods
- Refrigerate or freeze your leftovers no more than two hours after cooking
Which Nutrients Do You Need More Of During Pregnancy?
While the phrase “eating for two” may be an exaggeration, your calorie needs are higher during pregnancy. Women need an extra 340 calories per day during the second trimester. During the third trimester, calorie needs rise to an extra 450 calories per day.
Your needs for certain vitamins and minerals also increase during pregnancy. The nutrient needs that become elevated include (information from NIH):
- Folic acid/Folate (increases greatly, discussed in the next section)
- Iron (increases greatly, from 18 mg per day to 27 mg per day during pregnancy)
- Other B-complex vitamins (i.e., thiamin, riboflavin, niacin, pantothenic acid, vitamin B6, vitamin B12)
- Vitamin A
- Vitamin C
- Potassium (recently updated)
- Some of the less talked about trace minerals (chromium, copper, molybdenum)
- Total omega-3s
This may seem like an overwhelming list at first, but the needs for most of these nutrients only increase a little. The increase in food intake aligned with higher calorie needs will likely cover these small changes.
There are a few nutrients in this list that it is particularly important to pay attention to. Other nutrients that did not make the list above (because needs remain the same) are also very important. Some of the most important pregnancy nutrients are folic acid, iron, calcium, vitamin D, DHA, and iodine.
Not sure which foods to eat to get these critical nutrients? Don’t miss our article on the foods that you don’t want to miss during pregnancy. We’ve got a great list of suggestions for foods that will help to ensure you get the nourishment you need.
What’s The Deal With Folate and Folic Acid?
Folate is the natural form of vitamin B9 that you find in foods. Folic acid is the synthetic form of this vitamin, contained in fortified foods and supplements.
Though the natural source of most nutrients is preferable in most cases, folic acid is more bioavailable than folate. Additionally, folic acid taken as a supplement is slightly more bioavailable than folic acid in fortified foods.
This is why the general recommendation is that pregnant women should consume 400 mcg of folic acid per day from supplements or fortified foods. The rest of the 600 mcg of the dietary folate equivalent (i.e., 200 mcg) may come from other food sources.
Not all refined grains are fortified with this nutrient; check the ingredients list to see if folic acid is present. Beef liver is one of the best natural food sources of folate. A 3-ounce serving of the liver provides 215 mcg of this nutrient.
A study that came out in 2018 found that low-carb diets during pregnancy were linked to neural tube defects. It appeared to be related to a lower folic acid intake in the low-carb dieters. Pregnancy is no time to restrict nutrient-rich food types; please don’t risk it!
Final Thoughts About Healthy Pregnancy Diet
The changes that come with pregnancy can feel stressful at times. Conquering the fear of the unknown with education may be one technique to help put your mind at ease. I hope that this article gave you confidence in your ability to maintain a nutrient-rich diet during your pregnancy.
Women have been having healthy babies for as long as there have been humans. There is no need to let prenatal nutrition get you down. By taking some extra food safety precautions, eating a balanced diet, exercising, and taking your prenatal supplement, you’ll be giving your body what it needs.
Need some ideas for freezer meals for when the baby comes? Click on over to the recipe section, and let the nesting commence!
Summer is a registered dietitian located in Avon, Connecticut where she specializes in weight management, special diets, general nutrition, and avoidant/restrictive food intake disorder (ARFID). She is the developer and content creator behind the Summer Yule Nutrition website, where she shares evidence-based information on hot topics in food and nutrition.